Patient assessment of atrial fibrillation symptoms after being treated with catheter ablation may often not match physician assessments, according to a new study.
While a number of patients reported relief of symptoms after the treatment, many of those individuals actually experienced persistent arrhythmia despite the procedure, according to the study, which was published late last month in the JACC: Clinical Electrophysiology journal.
The study examined patients over 2 years, analyzing the success of AF ablation by evaluating patient reported and physician-assessed AF-related symptoms after the procedure.
A total of 54 patients completed the 2-year follow up, according to the study. Patients in the study showed improvements across AF-specific symptom questionnaire AF6 and were evaluated by physicians using the European Heart Rhythm Association classification at 6, 12 and 24 months. Recurrent arrhythmia was documented through electrocardiogram monitoring.
Researchers found that EHRA class and all 6 items on the AF6 questionnaire improved significantly overtime, with the greatest improvement during the 6 months post-ablation, with continued improvements up to 12 months.
While patient statuses improved, however, many patients reported a reduction in AF symptoms despite the procedure having a limited affect on the arrhythmia.
“There was also a discrepancy between patient-reported and physician-assessed outcomes after ablation. Freedom from AF and a low AF burden most often resulted in a reduction of symptoms, but symptom relief also occurred despite little effect on the arrhythmia,” study authors wrote.
The findings seem to mesh with current literature on the treatments, according to Dr. Biran Olshansky of the University of Iowa, who spoke to Medscape Cardiology.
“The economics being what it is, no one wants to know how much of the effect is placebo. How many of these procedures are being done inappropriately, at huge cost, without any real benefit more than placebo?” Dr. Olshansky told Medscape.